What Causes Shoulder Pain at Night?

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Shoulder pain at night can make it difficult to fall asleep, stay asleep or find a comfortable sleeping position. Some people experience relatively mild symptoms during the day but notice their shoulder becomes more painful when lying down at night.

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Night-time shoulder pain can have several possible causes, so identifying the underlying problem is important when symptoms persist.

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5 Common Causes of Shoulder Pain at Night

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1. Rotator Cuff-Related Shoulder Pain

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The rotator cuff is a group of muscles and tendons that helps control and stabilise your shoulder.

Rotator cuff-related shoulder pain may develop following an injury or gradually with repetitive lifting, overhead activities, sport or changes in physical workload.

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Symptoms may include:

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• Pain when lifting your arm

• Pain reaching overhead or behind your back

• Shoulder weakness

• Pain when lying on the affected shoulder

• Increased shoulder pain at night

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2. Shoulder Bursitis

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The shoulder contains small fluid-filled structures called bursae that help reduce friction between tissues.

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When the tissues around this area become irritated or sensitive, you may experience pain with certain shoulder movements and discomfort when lying on the affected side.

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3. Rotator Cuff Tendinopathy or Tear

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Changes or injuries to the rotator cuff tendons can cause shoulder pain, particularly during lifting and reaching activities.

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Some people with rotator cuff problems also experience significant night-time shoulder pain and difficulty finding a comfortable sleeping position.

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4. Frozen Shoulder

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Frozen shoulder (adhesive capsulitis) typically causes increasing pain and significant restriction in shoulder movement.

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Night pain can be particularly noticeable during the painful stages of frozen shoulder, and everyday movements such as dressing, reaching overhead or reaching behind your back may become difficult.

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5. Shoulder Arthritis

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Arthritis affecting the shoulder joints can cause pain, stiffness and reduced movement. Symptoms may sometimes become more noticeable during rest or at night.

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Not every case of night-time shoulder pain is caused by the shoulder itself. In some cases, pain may also be referred from the neck or another area, which is why an appropriate assessment can be helpful.

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How Can I Reduce Shoulder Pain at Night?

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Your treatment will depend on the cause of your shoulder pain, but some simple strategies may make sleeping more comfortable.

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Try to avoid sleeping directly on the painful shoulder. If you sleep on your opposite side, hugging or supporting the affected arm with a pillow may help. When sleeping on your back, placing a pillow underneath the arm can also provide additional support.

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During the day, temporarily modifying activities that significantly aggravate your symptoms may help while you gradually rebuild shoulder strength and capacity.

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How Can Physiotherapy Help Shoulder Pain?

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A physiotherapist can assess your shoulder movement, strength, function and symptoms to help determine factors contributing to your pain.

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Depending on your condition, physiotherapy may include:

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• Rotator cuff strengthening

• Shoulder and scapular exercises

• Mobility exercises

• Progressive resistance exercises

• Manual therapy

• Activity and load management

• Advice on sleeping positions

• A personalised home exercise program

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For many rotator cuff-related problems, rehabilitation involves gradually increasing the amount of load the shoulder can tolerate rather than simply resting the shoulder.

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Exercises may begin at a comfortable level and progress over time as your strength and symptoms improve.

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When Should I Get My Shoulder Checked?

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Consider a physiotherapy or medical assessment if your shoulder pain:

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• Regularly wakes you at night

• Persists or continues to worsen

• Makes it difficult to lift your arm

• Causes significant weakness or stiffness

• Started following an injury

• Interferes with work, exercise or everyday activities

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Sudden severe pain following significant trauma, obvious deformity, or marked weakness should be medically assessed promptly.

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Shoulder Pain Physiotherapy in Castle Hill & Chatswood

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Our physiotherapists provide assessment and rehabilitation for shoulder pain in Castle Hill and Chatswood, including rotator cuff-related shoulder pain, shoulder stiffness, sports injuries and persistent night-time shoulder pain.

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Following an assessment, we can develop an individualised treatment and exercise program to help reduce pain, restore movement and rebuild shoulder strength and function.

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Contact our Castle Hill or Chatswood physiotherapy clinic to book a shoulder pain assessment.

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